Citation Nr: 20003733 Decision Date: 01/16/20 Archive Date: 01/15/20 DOCKET NO. 14-33 494 DATE: January 16, 2020 REMANDED Entitlement to service connection for right upper extremity neuropathy, including as secondary to his service-connected right shoulder dislocation, is remanded. REASONS FOR REMAND The Veteran had active service from August 1995 to August 1998. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a May 2013 rating decision of the Department of Veterans Affairs (VA), Regional Office (RO), in Baltimore, Maryland. In April 2017, the Veteran testified in a Video Conference hearing before the undersigned. A transcript of the hearing is associated with the record. In April 2018, the Board remanded the above issue for further development. Unfortunately, a remand is again required. In this regard, per the Board’s April 2018 remand, the Veteran underwent a VA peripheral nerves examination in June 2019, wherein the examiner found that the Veteran did not have a current diagnosis of right upper extremity neuropathy, stating that there was no objective evidence of such, only subjective complaints. However, the Board notes that diagnostic testing was not performed. Additionally, the examiner was also asked to comment on a July 2011 nerve conduction study and electromyogram test. In particular, the nerve conduction study found that the Veteran had mild focal median neuropathy at the right wrist (mild right carpal tunnel syndrome) and a subtle lesion of the right axillary nerve. Otherwise, there was no evidence of generalized neuropathy or plexopathy. The electromyogram test was deemed abnormal. Evidence of chronic denervation was seen in the right supraspinatus, infraspinatus, and deltoid consistent with a long-standing C5 radiculopathy, or long-standing lesions of the right axillary and suprascapular nerves. There was no evidence of active denervation. Here, the examiner stated that he could not comment on prior diagnoses as he was not present at those examinations. Based on the above, the Board finds that another VA examination and opinion, which includes current diagnostic testing and comment on the Veteran’s relevant medical history throughout the appeal period, is required. The matters are REMANDED for the following action: 1. Obtain any recent, outstanding VA treatment records. 2. Schedule the Veteran for appropriate VA examination for his claimed right upper extremity neuropathy. The claims file and a complete copy of this REMAND must be made available to and reviewed by the examiner. The VA examination report should indicate that this has been accomplished. Nerve conduction testing and electromyogram testing should be performed. The examiner should specifically determine whether the Veteran has peripheral neuropathy of the right upper extremity. In rendering a diagnosis, the examiner should comment on the Veteran’s relevant medical history, including a July 2011 nerve conduction study and electromyogram test. The examiner is to opine on the following: (a) Whether the Veteran has a right upper extremity neuropathy diagnosis. (b) If the answer to (a) is yes, is it at least as likely as not (50 percent or better probability) that the Veteran’s right upper extremity neuropathy is related to his active duty service or any incident therein. (c) If the answer to (b) is that it is less likely than not, then is it at least as likely as not (50 percent or better probability) that the Veteran’s right upper extremity neuropathy is caused or aggravated by (where aggravation is any increase in severity beyond the natural progress of the disability) his service-connected right shoulder adhesive capsulitis. A complete rationale should be provided for all opinions provided. If any requested opinion cannot be provided without resorting to speculation, court cases require the examiner to explain why the opinion cannot be offered, and state whether the inability is due to the absence of any evidence or is due to the limits of scientific or medical knowledge. (Continued on next page)   3. Readjudicate the appeal. L. M. BARNARD Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board A.Z., Counsel The Board’s decision in this case is binding only with respect to the instant matter decided. This decision is not precedential, and does not establish VA policies or interpretations of general applicability. 38 C.F.R. § 20.1303.